Treatments

Treatments

Achilles Tendonitis/Tears

This is an overuse injury of the Achilles tendon, the band of tissue that connects the calf muscles at the back of the lower leg to your heel bone. Achilles tendinitis can be a problem for many people, especially those who exercise frequently. Achilles tendonitis often occurs in:

  • Runners who have recently increased the intensity or duration of their exercise
  • Middle-aged people who play sports, such as tennis or basketball, only on the weekends
  • Runners who wear worn-out shoes
  • Runners who run on hilly terrain
  • People with psoriasis or high blood pressure
  • Individuals who are obese

More serious cases of Achilles tendinitis can lead to tendon tears (ruptures) that may require surgical repair. The pain associated with Achilles tendinitis typically begins as a mild ache in the back of the leg or above the heel after running or other sports activity. Episodes of more severe pain may occur after prolonged running, stair climbing, or sprinting.

Treatments for Achilles tendinitis include strengthening exercises, over-the-counter medications like ibuprofen, icing, and compression. Surgery is sometimes needed in more severe cases.

Noninvasive arterial and venous duplex studies

Duplex Ultrasound can help detect blood flow blockages using sound waves. Podiatrists use a handheld device called a transducer to examine the potentially affected area. Duplex Ultrasound studies can help reveal a variety of conditions including:

  • Deep Vein Thrombosis, in which a blood clot formed in a vein can move into the lungs
  • Peripheral Arterial Disease, in which blood flow is obstructed to the arms or legs due to the narrowing of blood vessels
  • Aortic Aneurysms, a bulge in the body’s main artery, the bursting of which can cause serious bleeding and death
  • Other conditions such as mesenteric arterial disease, chronic venous disease, renal artery disease, and cerebrovascular disease

Duplex ultrasounds can also be used to map a patient’s veins before or after a coronary bypass.

Arthritis

If you feel pain and stiffness in your body or have trouble moving around, you might have arthritis. Most kinds of arthritis cause pain and swelling in your joints. Some kinds of arthritis can also cause problems in your organs, such as your eyes or skin. Types of arthritis include:

  • Osteoarthritis, the most common type of arthritis, which is often related to aging or to an injury.
  • Autoimmune arthritis, which happens when your body’s immune system attacks healthy cells in your body by mistake. Rheumatoid arthritis is the most common form of this kind of arthritis.
  • Juvenile arthritis, a type of arthritis that happens in children.
  • Infectious arthritis, an infection that has spread from another part of the body to the joint.
  • Psoriatic arthritis, which affects people with psoriasis.
  • Gout, a painful type of arthritis that happens when too much uric acid builds up in the body. It often starts in the big toe.

Osteoarthritis (OA) symptoms range from stiffness and mild pain that comes and goes to pain that doesn’t stop, even when you are resting or sleeping. Sometimes OA causes your joints to feel stiff after you haven’t moved them for a while, like after riding in the car.

Rheumatoid arthritis (RA) is an autoimmune disease, a type of illness that makes your body attack itself. RA causes pain, swelling, and stiffness that lasts for hours. People with RA often feel tired or run a fever.

Gout is one of the most painful kinds of arthritis. It most often happens in the big toe, but other joints can also be affected. Swelling may cause the skin to pull tightly around the joint and make the area red or purple and very tender.

Treatments can vary for different types of arthritis but often include rest, icing, hot baths, exercise, a healthy diet, use of special shoes or a cane, and medications like ibuprofen, naproxen, and acetaminophen.

Athlete’s Foot

This is a fungal infection that most often affects the space between the toes. Symptoms of Athlete’s Foot include itching, burning, scaling, inflammation, and blisters, which can often break, causing pain and swelling. Athlete’s Foot can also spread to other areas of the body, including the soles of the feet, toenails, groin, and underarms. You can get athlete’s foot from damp surfaces, such as showers, swimming pools, and locker room floors. To prevent Athlete’s Foot:

  • Keep your feet clean, dry, and cool
  • Wear clean socks
  • Don’t walk barefoot in public areas
  • Wear flip-flops in locker room showers
  • Keep your toenails clean and clipped short

Treatments usually include over-the-counter antifungal cream, but, for more serious infections, prescription medicines are sometimes prescribed.

Bunions

Bunions are bony bumps that form on the joint at the base of your big toe. A bunion forms when your big toe pushes against your next toe, forcing the joint of your big toe to get bigger and stick out. The skin over the bunion is often red and sore. Bunions can be caused by:

  • Wearing tight, narrow shoes
  • Inherited structural defects
  • Stress on the foot
  • Medical conditions, such as arthritis

Signs and symptoms of a bunion can include:

  • A bulging bump on the outside of the base of your big toe
  • Swelling, redness or soreness around your big toe joint
  • Thickening of the skin at the base of your big toe
  • Corns or calluses, which often develop where the first and second toes overlap
  • Persistent or intermittent pain

Treatments include changing shoes, padding, taping, splinting, wearing wide-toed shoes, using padded shoe inserts, icing, and medications like ibuprofen, naproxen, and acetaminophen. Surgery is sometimes performed in serious cases.

Corns and calluses

Corns and calluses are caused by pressure or friction on your skin. They often appear on feet where the bony parts of your feet rub against your shoes. Corns usually appear on the tops or sides of toes while calluses form on the soles of feet. Calluses can also appear on hands or other areas that are rubbed or pressed. Corns and calluses are common for those who:

  • Wear narrow shoes such as high heels
  • Have inherited defects such as hammer toes

Corns and calluses are not contagious but may become painful if they get too thick. In people with diabetes or decreased circulation, they can lead to more serious foot problems.

Treatments include changing shoes, using non-medicated pads, use of a washcloth or pumice stone, and cortisone injections for serious cases. Your podiatrist may shave part of the corn or callus off if it causes serious pain. Surgery may be recommended in rare cases.

Cavus foot

Cavus foot is the opposite of flat feet. Instead of having no arch, the foot will have an abnormally high arch. Causes include:

  • Muscle weakness
  • Friedreich’s Ataxia
  • Charcot–Marie–Tooth disease
  • Cerebral Palsy
  • Stroke
  • Spina Bifida
  • Polio
  • Inherited defects

The origin and cause of the cavus foot usually determines its symptoms. People with an inherited cavus foot who are sufficiently flexible sometimes do not suffer any symptoms. For those who do suffer, symptoms include:

  • Calluses
  • Shoe-fitting problems
  • Knee pain
  • Back pain
  • Tripping
  • Ankle arthritis
  • Achilles tendonitis
  • Hammertoes or claw toes

Treatments include special shoes, braces, and orthotics. In some cases, surgery will be required to effectively treat the symptoms.

Cellulitis

Cellulitis is an infection of the skin and deep underlying tissues. Group A strep (streptococcal) bacteria are the most common cause. The bacteria enter your body when you get an injury such as a bruise, burn, surgical cut, or wound. Several factors can place you at greater risk of developing cellulitis, including:

  • Injuries, including cuts, fractures, or burns
  • Skin disorders, such as eczema, athlete’s foot, chicken pox, and shingles
  • Chronic swelling of your arms or legs
  • Intravenous drug use
  • Obesity

Symptoms of cellulitis can include:

  • Fever and chills
  • Tenderness
  • Pain
  • Skin dimpling
  • Swollen glands or lymph nodes
  • A rash with painful, red, tender skin. The skin may blister and scab over.

Cellulitis is usually treated with antibiotics. They may be oral in mild cases, or intravenous (through the vein) for more severe cases. Other treatments include cleaning the affected area, elevation, and ointments.

Charcot Foot

Charcot foot is the breakdown or weakening of the bones in the foot, usually resulting from diabetic nerve damage. Charcot foot can cause serious problems including ulcers and lack of feeling in the foot. Symptoms include:

  • Poor circulation
  • Warmness in the feet
  • Redness, swelling, and discoloration
  • Diabetic ulcers

Treatments can include controlling blood sugar levels, casting/immobilizing the foot, special shoes, or braces. Serious cases may require surgery.

Diabetic Preventative Care

Diabetic preventative care is essential and requires a team of medical professionals, including your podiatrist. Vascular and nerve problems can complicate the healing process from injuries, and individuals with diabetic neuropathy may injure their feet without even knowing it. There are many ways to help ensure your foot health if you have diabetes, including:

  • Diabetic shoes, socks, and sneakers
  • Routine foot screenings
  • Checking your own feet on a daily basis
  • Keeping good personal hygiene
  • Keeping blood sugar levels stable

It’s essential to take good care of your feet if you have diabetes; complications from ulcers and infections can be severe and even life threatening.

Drop foot

This abnormality in walking occurs when an individual cannot lift the front of their foot (forefoot) when they walk. Drop foot is usually a symptom of neuromuscular disorders like Multiple Sclerosis or ALS (Lou Gherig’s disease), rather than a condition in itself.

Equinus

Equinus occurs when the Achilles tendon is shorter than it should be, leading an individual to be unable to flex the top foot upward toward the leg. Individuals with Equinus find ways to compensate for their limited range of motion, which can lead to pressure on the knees and lower back pain. Equinus can often be caused by:

  • Tightness in the Achilles tendon
  • Hammer toe
  • Uneven leg length
  • Wearing high heels
  • Ankle injuries
  • Plantar Fasciitis

Equinus can cause a variety of foot problems, including:

  • Flatfoot
  • Ankle pain
  • Shin splints
  • Tendonitis
  • Calf cramping

Treatments may include splints, heel lifts, orthotics, physical therapy, and stretching. Surgery may be necessary in rare cases.

Flat Feet

When the arches of the heels collapse, the entire foot (or most of it) is in contact with the ground when walking. Having flat feet may result in discomfort when you do vigorous exercise. There are multiple types of flat feet, including:

  • Flexible flat foot, in which the arch of the foot can be seen only when the feet are lifted off the ground (often painless)
  • Short Achilles tendon, which can often cause people to walk on their toes
  • Posterior tibial tendon dysfunction, which results from injury to, swelling of, or tearing of the tendon connecting your calves to your ankles

People who are at high risk of flat feet include:

  • Individuals with a family history of flat feet
  • Obese people
  • People suffering from hypertension
  • Individuals with Cerebral Palsy and other diseases that affect the muscles

Treatments include orthotics, special diet and exercise programs, special shoes or supports, medications like ibuprofen and naproxen. Surgery may be recommended in rare cases.

Foot sprains/fractures

Foot or ankle sprains are a soft tissue injury. Most often, a sprain occurs when an injury pulls, stretches, or tears the ligaments that connect bone to bone. A fracture is actually a break in the bone. Injuries are the most common causes of foot and ankle sprains and fractures. Many fractures and sprains occur during sports. Foot sprains/fractures are common among:

  • Football and basketball players
  • Runners
  • Gymnasts and dancers
  • People who trip or stumble on uneven ground

Pain, swelling, bruising, and difficulty walking on the affected foot or ankle are the most common symptoms of a sprained or fractured foot or ankle.

Treatments include rest, icing, compression, and elevation. In rare cases, a podiatrist may use metal plates or screws to fix broken bones.

Foot and Ankle Fractures

Foot and ankle fractures are breaks in one or more ankle bones. These fractures may:

  • Be partial (the bone is only partially cracked, not all the way through)
  • Be complete (the bone is broken through and is in 2 parts)
  • Occur on one or both sides of the ankle

Severe ankle fractures may require surgery. Fractures may need surgery if:

  • The ends of the bone are out of line with each other (displaced)
  • The fracture extends into the ankle joint
  • Tendons or ligaments (tissues that hold muscles and bones together) are torn
  • Your doctor thinks your bones may not heal properly without surgery
  • In children, the fracture involves the part of the ankle bone where bone is growing

When surgery is needed, it will likely involve inserting metal pins, screws, or plates to hold the bones in place as the fracture heals. Casts, splints, and crutches are often prescribed as part of the surgical healing process. Pain can be addressed using elevation and medications like ibuprofen, naproxen, and acetaminophen.

Gait Analysis

An analysis of how someone walks. A variety of problems can cause an abnormal gait (or walk) and lead to problems with walking. These include:

  • Injuries, diseases, or abnormal development of the muscles or bones of your legs or feet
  • Movement disorders such as Parkinson’s disease
  • Diseases such as arthritis or multiple sclerosis
  • Vision or balance problems

Walking abnormalities are unusual and uncontrollable walking patterns. They are usually due to diseases or injuries to the legs, feet, brain, spinal cord, or inner ear. Some common abnormal gates include:

  • Propulsive gait: a stooped, stiff posture with the head and neck bent forward
  • Scissors gait: legs flexed slightly at the hips and knees like crouching, with the knees and thighs hitting or crossing in a scissors-like movement
  • Spastic gait: a stiff, foot-dragging walk caused by a long muscle contraction on one side
  • Steppage gait: foot drop where the foot hangs with the toes pointing down, causing the toes to scrape the ground while walking, requiring someone to lift the leg higher than normal when walking
  • Waddling gait: a duck-like walk that may appear in childhood or later in life

Abnormal gait may be caused by diseases in different areas of the body. General causes of abnormal gait may include:

  • Arthritis of the leg or foot joints
  • Conversion disorder (a psychological disorder)
  • Foot problems (such as a callus, corn, ingrown toenail, wart, pain, skin sore, swelling, or spasms)
  • Fracture
  • Injections into muscles that causes soreness in the leg or buttocks
  • Infection
  • Injury
  • Legs that are of different lengths
  • Myositis
  • Shin splints
  • Shoe problems
  • Tendonitis
  • Torsion of the testis

Treatment of walking problems depends on the cause. Physical therapy, surgery, or mobility aids may help.

Mature Adults

These soft tissue lumps most commonly occur on the hands or feet.

Ganglionic Cysts

Pain in the feet can be common as you get older. As aging occurs, conditions that affect the foot may include:

  • Ingrown toes
  • Corns and calluses
  • Athlete’s foot and fungal nails
  • Plantar fasciitis
  • Tendonitis
  • Hammer toes
  • Bunions
  • Neuromas

Diabetes can also cause many problems for the limbs and should be kept under control to ensure healthy feet.

Treatments to prevent age-related foot problems can include specialized footwear and socks, regular cleaning, and moisturizer.

Gout

Gout is a common, painful form of arthritis that causes swollen, red, hot and stiff joints. Gout happens when uric acid builds up in your body. Uric acid comes from the breakdown of substances called purines. Purines are in your body’s tissues and in foods such as liver, dried beans, peas, and anchovies.

Normally, uric acid dissolves in the blood. It passes through the kidneys and out of the body in urine. But sometimes uric acid can build up and form needle-like crystals. When they form in your joints, it is very painful. The crystals can also cause kidney stones.

Often, gout first attacks your big toe. It can also attack ankles, heels, knees, wrists, fingers, and elbows. At first, gout attacks usually get better in days. Eventually, attacks last longer and happen more often.

You are more likely to get gout if you:

  • Are a man
  • Have family member with gout
  • Are overweight or obese
  • Drink alcohol
  • Have been exposed to lead
  • Eat too many foods rich in purines
  • Take medications including diuretics, aspirin, levodopa, and niacin

Gout can be hard to diagnose. Your doctor may take a sample of fluid from an inflamed joint to look for crystals. Gout can be treated with a variety of medicines.

Hammertoe

Hammertoe is a contracture (bending) deformity of one or both joints of the second, third, fourth, or fifth (little) toes. This abnormal bending can put pressure on the toe when wearing shoes, causing problems to develop.

Hammertoes usually start out as mild deformities and get progressively worse over time. In the earlier stages, hammertoes are flexible and the symptoms can often be managed with noninvasive measures. But if left untreated, hammertoes can become more rigid and will not respond to nonsurgical treatment.

Because of the progressive nature of hammertoes, they should receive early attention. Hammertoes never get better without some kind of intervention. Hammertoes may be caused by:

  • Muscle/tendon imbalance
  • Inherited defect
  • Ill-fitting shoes

Common symptoms of hammertoes include:

  • Pain or irritation of the affected toe when wearing shoes
  • Corns and calluses
  • Inflammation
  • Contracture of the toe
  • Open sores (in severe cases)

There are a variety of treatment options for hammertoes including non medicated pads, changing footwear, orthotics, corticosteroid injections, splints, straps, and medications including ibuprofen. Surgery is sometimes needed in serious cases.

Heel pain

While heel pain has many causes, it is generally the result of faulty biomechanics (walking gait abnormalities) that place too much stress on the heel bone and the soft tissues that attach to it. Common causes of heel pain include:

  • Heel spurs
  • Injuries
  • Bruises incurred while walking, running, or jumping on hard surfaces
  • Wearing poorly constructed footwear (such as flimsy flip-flops)
  • Being overweight

Preventing heel pain involves wearing well-fitting shoes with shock-absorbent soles, warming up and stretching before exercise, resting and nutrition, and losing weight if overweight or obese.

Infections

Infections are caused by bacteria, which are living things that have only one cell. Most bacteria won’t hurt you—less than 1 percent of the different types make people sick. Many are helpful. Some bacteria help to digest food, destroy disease-causing cells, and give the body needed vitamins. Bacteria are also used in making healthy foods like yogurt and cheese.

But infectious bacteria can make you ill. They reproduce quickly in your body. Many give off chemicals called toxins, which can damage tissue and make you sick. Examples of bacteria that cause infections include Streptococcus, Staphylococcus, and E. coli.

Antibiotics are the usual treatment. When you take antibiotics, follow the directions carefully. Each time you take antibiotics, you increase the chances that bacteria in your body will learn to resist them causing antibiotic resistance. Later, you could get or spread an infection that those antibiotics cannot cure.

Ingrown Toenails/Nail Problems

Conditions that affect the health of your nails can be a clue to your overall health. Healthy nails are usually smooth and consistent in color. Specific types of nail discoloration and changes in growth rate can be signs of lung, heart, kidney, and liver diseases, as well as diabetes and anemia. White spots and vertical ridges are harmless. Nail problems that sometimes require treatment include:

  • Bacterial and fungal infections
  • Ingrown nails
  • Tumors
  • Warts

Keeping your nails clean, dry, and trimmed can help you avoid some problems. Do not remove the cuticle, which can cause infection.

Our nails often reflect our general state of health. Changes in the nail, such as discoloration or thickening, can signal health problems, including liver and kidney disease, heart and lung conditions, anemia, and diabetes.

Symptoms that could signal nail problems include changes in color, shape and/or thickness, swelling of the skin around the nails, bleeding or discharge, and pain.

Lymphedema

This type of swelling occurs when lymph, a fluid that contains white blood cells and defends against germs, builds up in your body’s soft tissues. It can build up when the lymph system is damaged or blocked and usually happens in the arms or legs. Causes of lymphedema include:

  • Infection
  • Cancer
  • Scar tissue from radiation therapy or surgical removal of lymph nodes
  • Inherited conditions in which lymph nodes or vessels are absent or abnormal

Lymphedema signs and symptoms, which occur in your affected arm or leg, include:

  • Swelling of part or all of your arm or leg, including fingers or toes
  • A feeling of heaviness or tightness
  • Restricted range of motion
  • Aching or discomfort
  • Recurring infections
  • Hardening and thickening of the skin (fibrosis)

Treatment can help control symptoms and includes exercise, compression devices, skin care, and massage.

Acoustic neuromas

These benign tumors develop on the nerve that connects the ear to the brain. The tumor usually grows slowly and as it grows, it presses against the hearing and balance nerves. At first, you may have no symptoms or mild symptoms. They can include:

  • Loss of hearing on one side
  • Ringing in ears (tinnitus)
  • Dizziness, vertigo and balance problems
  • Facial numbness and very rarely, weakness

The tumor can also eventually cause numbness or paralysis of the face. If it grows large enough, it can press against the brain, becoming life-threatening.

Acoustic neuromas can be difficult to diagnose, because the symptoms are similar to those of middle ear problems. Ear exams, hearing tests, and scans can show if you have it.

If the tumor stays small, you may only need to have it checked regularly. If you do need treatment, surgery and radiation are options. If the tumors affect both hearing nerves, it is often because of a genetic disorder called neurofibromatosis.

Diabetic neuropathy

This peripheral nerve disorder is caused by diabetes or poor blood sugar control. The most common types of diabetic neuropathy result in problems with sensation in the feet. It can develop slowly after many years of diabetes or may occur early in the disease. The symptoms include:

  • Numbness
  • Pain
  • Tingling in the feet or lower legs

The pain can be intense and require treatment to relieve the discomfort. The loss of sensation in the feet may also increase the possibility that foot injuries will go unnoticed and develop into ulcers or lesions that become infected.

In some cases, diabetic neuropathy can be associated with difficulty walking and some weakness in the foot muscles.

Treatments include controlling blood sugar levels with diet and medication, wearing proper fitting shoes, regularly checking the feet for cuts and infection, warm baths, elastic stockings, regular walking, and medications like analgesics, antidepressants (at low doses), and some anticonvulsant medications.

Pediatric Deformities

Pediatric deformities are problems (usually inherited) that affect the bones, muscles, and tendons of the feet in children. Some common pediatric foot deformities include:

  • Calcaneovalgus foot, which occurs when the foot seems to bend upwards
  • Congenital vertical talus, which has a similar upward bend to calcaneovalgus, but is more inflexible and often related to other congenital defects
  • Clubfoot, which is a more serious deformity that involves the feet being twisted

Some children with pediatric foot deformities do not have any symptoms, and those with mild symptoms are often prescribed nonsurgical treatments, but surgery is sometimes required in serious cases.

Phlebitis

Phlebitis occurs when a vein becomes inflamed. When the inflammation is the result of blood clots, the condition is called thrombophlebitis. This may result in irritation, pain, and blocked blood flow in the veins. Causes may include:

  • Blood pooling as a result of inactivity
  • Being obese
  • Injuries to the limbs
  • Trauma
  • Inherited defects

Symptoms vary and may include:

  • Throbbing or burning
  • Hardness, warmness or tenderness of the afflicted area
  • Fever

Treatments may include medications like ibuprofen, antibiotics (if an infection has also occurred), warm compresses, compression stockings, and various blood-thinners (if the diagnosis is Deep Vein Thrombosis).

Plantar Fasciitis

Refers to problems with the plantar fascia, which is a band of tissue, much like a tendon, that starts at your heel and goes along the bottom of your foot. It attaches to each one of the bones that form the ball of your foot. The plantar fascia works like a rubber band between the heel and the ball of your foot to form the arch of your foot.

If the band is short, you’ll have a high arch, and if it’s long, you’ll have a low arch, or what some people call flat feet. A pad of fat in your heel covers the plantar fascia to help absorb the shock of walking. Damage to the plantar fascia can be a cause of heel pain.

As a person gets older, the plantar fascia becomes less like a rubber band and more like a rope that doesn’t stretch very well. The fat pad on the heel becomes thinner and can’t absorb as much of the shock caused by walking. The extra shock damages the plantar fascia and may cause it to swell, tear or bruise. You may notice a bruise or swelling on your heel.

Other risk factors for plantar fasciitis include:

  • Overweight and obesity
  • Diabetes
  • Spending most of the day on your feet
  • Becoming very active in a short period of time
  • Being flat-footed or having a high arch

Treatments include cutting back on excessive running or walking, orthotics, splints, taping, corticosteroid injections, weight loss, stretching exercises, and medications like acetophenamin, ibuprofen, and naproxen. Surgery is rarely required.

Orthotics

Orthotics are devices that help limit, guide, or immobilize a part of the body. In podiatry, this usually means shoe inserts. Orthotics are often custom made for individual patients and take into account the shape and size of the foot and the condition for which the patient is being treated. Orthotics are often used to treat:

  • Foot and heel pain
  • Arch pain
  • Knee problems
  • Diabetic nerve damage/neuropathy

Orthotics can be essential as a part of preventative podiatry; combined with physical therapy, orthotics, if used early enough, can often reduce or eliminate the need for surgery.

Sesamoiditis

Pain and inflammation of the sesamoid bone, which is one of the small bones in the feet. Symptoms include:

  • Pain in the base of the big toe
  • Pain when walking, especially when wearing uncomfortable shoes
  • Warmth and swelling
  • Redness of the big toe

Treatments include orthotics, special shoes, corticosteroid injections, and medications like acetophenamin, ibuprofen, and naproxen.

Spider veins

Spider veins are formed by the dilation of a small group of blood vessels located close to the surface of the skin. Although they can appear anywhere on the body, spider veins are most commonly found on the face and legs.

They usually pose no health hazard but may produce a dull aching in the legs after prolonged standing and indicate more severe venous disease. The exact cause of spider veins is unknown, although the primary factors that contribute to spider veins are believed to include:

  • Heredity defects
  • Pregnancy
  • Trauma
  • Aging
  • Sun damage
  • Hormonal influences

More than 40 percent of women have some form of varicose vein condition including spider veins, with an increasing incidence of venous disease as one gets older, so that up to 80 percent of women have some form of venous disease by age 80. Slightly more women than men have varicose and spider veins.

Treatments include exercise such as walking or cycling, weight loss, compression stockings, and avoiding sitting or standing for long periods of time.

Sports Medicine

A branch of medicine that focuses on providing treatment for athletes and individuals who engage in exercise in order to increase their performance as well as to prevent and treat injuries.

Tendinitis

The severe swelling of tendons, which are the flexible bands of tissue that connect muscles to bones. Tendons help your muscles move your bones.

Bursitis and tendinitis are both common conditions that involve inflammation of the soft tissue around muscles and bones, most often in the shoulder, elbow, wrist, hip, knee, or ankle.

Tendinitis usually happens after repeated injury to an area such as the wrist or ankle. It causes pain and soreness around a joint. Some common forms of tendinitis are named after the sports that increase their risk. They include:

  • Tennis elbow
  • Golfer’s elbow
  • Pitcher’s shoulder
  • Swimmer’s shoulder
  • Jumper’s knee

A bursa is a small, fluid-filled sac that acts as a cushion between a bone and other moving parts: muscles, tendons, or skin. Bursae are found throughout the body. Bursitis occurs when a bursa becomes inflamed (redness and increased fluid in the bursa).

Treatments include rest, wrapping or elevating the affected area, and medicines can help. Ice is helpful for recent, severe injuries. Other treatments include stretching, altering or eliminating various sports movements, ultrasound, physical therapy, steroid injections, and surgery.

Toenail fungus

Also called onychomycosis, this is an infection underneath the surface of the toenail caused by fungi. When the tiny organisms take hold, the nail often becomes darker in color and smells foul. Debris may collect beneath the nail plate, white marks frequently appear on the nail plate, and the infection is capable of spreading to other toenails, the skin, or even the fingernails.

If ignored, the infection can spread and possibly impair your ability to work or even walk. The resulting thicker nails are difficult to trim and make walking painful when wearing shoes. Onychomycosis can also be accompanied by a secondary bacterial or yeast infection in or about the nail plate.

Causes include:

  • Walking barefoot in damp areas such as swimming pools, locker rooms, or showers
  • Injury to the nail bed
  • Diabetes, circulatory problems, or immune-deficiency conditions
  • Excessive perspiration and/or a history of athlete’s foot

Symptoms are characterized by a progressive change in a toenail’s quality and color, which is often ugly and embarrassing.

A daily routine of cleansing over a period of many months may temporarily suppress mild infections. White markings that appear on the surface of the nail can be filed off, followed by the application of an over-the-counter liquid antifungal agent. However, even the best over-the-counter treatments may not prevent a fungal infection from coming back.

Treatments may include prescribing topical or oral medication, and debridement (removal of diseased nail matter and debris) of an infected nail.

Prevention includes the regular cleaning and clipping of toenails, avoiding wearing hosiery that is too tight, changing shoes and socks more than once a day, and avoiding applying polish to nails that appear infected.

Ulcers and Wound Care

Essential medical treatment for individuals who experience ulcers, which are open sores inside or on the surface of the body, or wounds, which involve broken tissue, usually on the surface of the body. Types of wounds include:

  • Abrasions, which include road rashes
  • Incisions, which are caused by sharp objects and often bleed profusely
  • Lacerations, which are similar to incisions but involving deeper cuts and tearing
  • Punctures, small holes that may be deep and may damage internal organs
  • Avulsions, which involve major skin tearing (usually from serious accidents) and often bleed very rapidly

While small wounds may be treated at home, larger wounds may require medical intervention where they are treated with medical glue, stitches, or sutures.

Varicose veins

Swollen, twisted veins that you can see just under the skin. They usually occur in the legs, but also can form in other parts of the body. Hemorrhoids are a type of varicose vein.

Your veins have one-way valves that help keep blood flowing toward your heart. If the valves are weak or damaged, blood can back up and pool in your veins. This causes the veins to swell, which can lead to varicose veins.

Varicose veins are very common. You are more at risk if you are older, a female, obese, don’t exercise or have a family history. They can also be more common in pregnancy. Doctors often diagnose varicose veins from a physical exam. Sometimes you may need additional tests.

Exercising, losing weight, elevating your legs when resting, and not crossing them when sitting can help keep varicose veins from getting worse. Wearing loose clothing and avoiding long periods of standing can also help. If varicose veins are painful or you don’t like the way they look, your doctor may recommend procedures to remove them.

Warts

These skin growths are caused by an infection with human papillomavirus, or HPV. Types of warts include:

  • Common warts, which often appear on your fingers
  • Plantar warts, which show up on the soles of your feet
  • Genital warts, which are a sexually transmitted disease
  • Flat warts, which appear in places you shave frequently

In children, warts often go away on their own. In adults, they tend to stay. If they hurt or bother you, or if they multiply, you can remove them. Chemical skin treatments usually work. If not, various freezing, surgical and laser treatments can remove warts.

X-rays

X-ray imaging creates pictures of the inside of your body using a type of radiation called electromagnetic waves. The images show the parts of your body in different shades of black and white. This is because different tissues absorb different amounts of radiation. Calcium in bones absorbs x-rays the most, so bones look white. Fat and other soft tissues absorb less and look gray. Air absorbs the least, so lungs look black.

The most familiar use of x-rays is checking for broken bones, but x-rays are also used in other ways. For example, chest x-rays can spot pneumonia. Mammograms use x-rays to look for breast cancer.

There are many types of x-rays which may be used for different purposes. Computed tomography (CT), fluoroscopy, and radiography (the “conventional x-ray,” including mammography) all use ionizing radiation to generate images of the body. Ionizing radiation is a form of radiation that has enough energy to potentially cause damage to DNA and may elevate a person’s lifetime risk of developing cancer.

Different types of X-rays include:

  • Radiography: a single image is recorded for later evaluation. Mammography is a special type of radiography to image the internal structures of breasts.
  • Fluoroscopy: a continuous x-ray image is displayed on a monitor, allowing for real-time monitoring of a procedure or passage of a contrast agent (“dye”) through the body. Fluoroscopy can result in relatively high radiation doses, especially for complex interventional procedures (such as placing stents or other devices inside the body), which require fluoroscopy be administered for a long period of time.
  • CT scans: many x-ray images are recorded as the detector moves around the patient’s body. A computer reconstructs all the individual images into cross-sectional images or “slices” of internal organs and tissues. A CT exam involves a higher radiation dose than conventional radiography because the CT image is reconstructed from many individual x-ray projections.

When you have an x-ray, you may wear a lead apron to protect certain parts of your body. The amount of radiation you get from an x-ray is extremely small. For example, a chest x-ray gives out a radiation dose similar to the amount of radiation you’re naturally exposed to from the environment over 10 days.